Small airways disease in an Operation Desert Storm Deployer: Case report and review of the literature on respiratory health and inhalational exposures from Gulf War I

Am J Ind Med. 2018 Oct;61(10):793-801. doi: 10.1002/ajim.22893. Epub 2018 Aug 16.

Abstract

Constrictive Bronchiolitis (CB) has been reported in US Operation Iraqi Freedom/Enduring Freedom (OIF/OEF) deployers but not in those from prior US conflicts. A 62-year old presented with progressive dyspnea 13 years after deployment to the Persian Gulf in 1991-1992, where he was exposed to burning oil well fire emissions, dust storms, and other potential airborne hazards. In 2014, after a chest computed tomography (CT) scan demonstrated diffuse mosaic attenuation, he underwent surgical lung biopsy, which revealed CB. Deployers from both GWI and OIF/OEF share many exposures. As respiratory symptoms are a feature associated with Gulf War medically unexplained illness, there may be a role for renewed interest in evaluating GWI Veterans with unexplained respiratory symptoms for conditions such as CB, which may result from exposures relevant to deployers from both conflicts.

Keywords: Gulf War I; Persian Gulf; bronchiolitis; military; respiratory.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Azithromycin / therapeutic use
  • Biopsy
  • Bronchiolitis Obliterans / diagnostic imaging*
  • Bronchiolitis Obliterans / pathology
  • Bronchiolitis Obliterans / physiopathology
  • Bronchiolitis Obliterans / therapy
  • Fires
  • Forced Expiratory Volume
  • Gulf War*
  • Humans
  • Inhalation Exposure
  • Male
  • Middle Aged
  • Occupational Exposure*
  • Oil and Gas Fields
  • Pulmonary Diffusing Capacity
  • Respiratory Therapy
  • Tomography, X-Ray Computed
  • Veterans*
  • Vital Capacity

Substances

  • Adrenal Cortex Hormones
  • Anti-Bacterial Agents
  • Azithromycin

Grants and funding